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Name *First and last name

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What types of services are you interested in ?Lab kits1-on-1 coachingUpcoming Course

Please give some details on the health symptoms that have you interested in my services. How long have they been ongoing? What has been done/what specialists have you seen this far?

If you could change one thing about your health/body, what would it be? And how would it change your life?

Anything else you'd like to mention or ask?

Are you at a place in your life right now where you are ready to commit in investing in your health for these types of services? YesNot Right NowMaybe

The investment to work together can be anywhere from a four-figure to five-figure investment. I only work with an exclusive & limited amount of clients throughout the year. Are you mentally & financially ready to commit to your health in this way? Absolutely, I'm inYes, but I might need a monthly retainer planI'm not sure yetNo, I do not want to go forward. Finances are the barrier.

Send me a copy of my responses.YesNo